Self Efficacy And Religiosity As Determinants Of Cognitive Behavioural Therapy Treatment Outcome In Substance Use Disorders

The study examined the effectiveness of self efficacy component of the health action process approach (HAPA), and religiosity in the treatment of substance use disorders. Results indicated that belief leading to the adoption, initiation and maintenance of health behaviours must be explicitly conceived by patients as a process that consists of at least a motivation phase and volition phase, leading to positive outcomes in compliance and abstinence maintenance for the treatment of substance use disorders. However if patients do not believe in their capability to perform the desired action, they would fail to adopt, initiate and maintain it leading to frequent relapses. Using group cognitive-behaviour therapy among male patients, self efficacy and religiosity were found to be effective components of cognitive behaviour therapy in substance use disorders as this led to high compliance and sustained abstinence over a six month assessment period, when compared with patients who did not have this approach. Key Words: health action process approach, self efficacy, religiosity, cognitive behaviour therapy, substance use disorder

Adherence to highly active antiretroviral therapy in depressed patients with HIV/AIDS attending a Nigerian university teaching hospital clinic

Objective:  Key words:  Medication adherence; Depressive disorder; Highly Active Antiretroviral Therapy; HIV infectionTo determine the prevalence of depressive disorder in patients with HIV/AIDS receiving HAART; to determine the effect of depressive disorder on adherence to antiretroviral therapy; and to determine the significance of the association. Method: The study was conducted amongst outpatients of Ahmadu Bello University Teaching Hospital, Zaria. A sociodemographic and drug adherence questionnaire was administered. The Centre for Epidemiological Studies Depression Scale (CES-D) was used to screen for depressive symptoms while the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) was used to confirm the diagnosis of depressive disorder. Results: A total of 310 patients with HIV/AIDS receiving HAART participated in the study. 68.4% were female and the mean age was 35.5 (± 8.97 years). 37.4% had secondary education, while 27.1% had tertiary education. Sixty-six participants (21.3%) had significant depressive symptoms while 14.2% met ICD-10 diagnostic criteria for depressive disorder. Overall, 73% of participants had good adherence to HAART. 63.6% of participants with depressive disorder had poor adherence to HAART compared to 21.1% of participants without depressive disorder (

Alcohol-Related Problems And High Risk Sexual Behaviour In Patients With Hiv/Aids Attending Medical Clinic In A Nigerian University Teaching Hospital

This study was designed to determine the rate of alcohol related-problems in patients with HIV/ AIDS and its association with high risk sexual behavior. A consecutive sample of 120 patients with HIV/AIDS attending the Medical Out-patient Department (M.O.P.D) in Ahmadu Bello University Teaching Hospital (A.B.U.T.H), Zaria was assessed. All participants were screened for alcohol related problems using the Alcohol Use Disorder Identification Test (AUDIT). High risk sexual behavior was assessed using the HIV Risk-taking Behavior Questionnaire (HRBQ). Alcohol-related problems were found in 28.3% of participants (10% had hazardous use, 3.3% had harmful use and 15% had alcohol dependence). There was a significant association between alcohol-related problems and risky sexual behavior. Alcohol-related problems are fairly common in people already infected with HIV/AIDS and are associated with high-risk sexual behavior. Thus, screening and treatment should be part of an effective HIV intervention program. Key Words: Alcohol related problems, high-risk sexual behavior, hazardous use, harmful use, alcohol dependenc

Spatio-temporal Models of Lymphangiogenesis in Wound Healing

Several studies suggest that one possible cause of impaired wound healing is failed or insufficient lymphangiogenesis, that is the formation of new lymphatic capillaries. Although many mathematical models have been developed to describe the formation of blood capillaries (angiogenesis), very few have been proposed for the regeneration of the lymphatic network. Lymphangiogenesis is a markedly different process from angiogenesis, occurring at different times and in response to different chemical stimuli. Two main hypotheses have been proposed: 1) lymphatic capillaries sprout from existing interrupted ones at the edge of the wound in analogy to the blood angiogenesis case; 2) lymphatic endothelial cells first pool in the wound region following the lymph flow and then, once sufficiently populated, start to form a network. Here we present two PDE models describing lymphangiogenesis according to these two different hypotheses. Further, we include the effect of advection due to interstitial flow and lymph flow coming from open capillaries. The variables represent different cell densities and growth factor concentrations, and where possible the parameters are estimated from biological data. The models are then solved numerically and the results are compared with the available biological literature.Comment: 29 pages, 9 Figures, 6 Tables (39 figure files in total

Determinants of psychoactive substance use among incarcerated delinquents in Nigeria

The objective of the study was to identify the prevalence of psychoactive substance use among incarcerated delinquents in Nigeria and its determinants. The total inmate population of 401 individuals were interviewed over a period of four weeks using an interviewer administeredquestionnaire that assessed for socio demographic, forensic, and drug use history among other variables. All the respondents were males, with a mean age of 20.6 ± 3.1 years, ranging from 12 to 39 years and had spent an average of 16.1 ± 9.9 months. The average age of first use was 12.6± 5.9 years. The prevalence of lifetime and current use of any substance was 88.0% and 64.3% respectively. Prior arrest, being sexually active and family drug use significantly (p<0.05) predicted lifetime use of any substance while being raised in a monogamous family was protective. Priorarrest, family drug use, and being sexually active significantly (p<0.05) increased lifetime use of illicit substances while being raised from a monogamous home significantly (p<0.05) reduced same. Prior arrest and substance use before incarceration significantly (p<0.05) predicted currentuse of any substance. Being sexually active and substance use before incarceration significantly (P<0.05) predicted current use of illicit substances while high self esteem and being the first born was protective. Since substance use prevalence is high among incarcerated delinquents,the incorporation of substance abuse screening and treatment as part of their programmeme is advocated.Key Words: Substance use, delinquents, incarceration, Nigeria

Diagnostic challenges and psychosocial impacts of hypersomnia in a Nigerian adolescent: A case report

Hypersomnia, a disorder of sleep characterized by excessive quantity of sleep and excessive daytime sleepiness (EDS), could adversely affect health outcomes in childhood. To highlight diagnostic challenges and the impact of childhood hypersomnia in a resource limited setting, a 14year old Nigerian who presented with a seven year history of hypersomnia was studied. Screening for sleep disorder using BEARS sleep algorithm and assessment for EDS using the Epworth Sleepiness Scale were both positivefor EDS. The assessment of sleep hygiene using the Adolescent Sleep Hygiene Scale was normal and the use of Raven’s Progressive Matrices to assess intelligence was also normal. There was no contributory pastmedical history or demonstrable etiology. Magnetic Resonance Imaging (MRI) of the brain, Electro Encephalogram (EEG), assay of serum electrolytes were all normal while screening test for trypanosomiasis was negative. Poor level of awareness, high cost of evaluation and limited facilities for diagnosis of sleep disorder were the major diagnostic challenges. Depression, poor academic performance, suicidal ideation andstigmatization were all associated with hypersomnia in the patient.Keywords: Hypersomnia, adolescence, depression, sleep disorders, diagnostic challenges

Factors associated with treatment gap in children and adolescents with epilepsy in a rural Nigerian community.

Background: The campaign against epilepsy is hampered by the difference between those with the active disorder and the number of them receiving appropriate treatment (treatment gap) in sub-Saharan Africa. Identifying the determinants of this gap is crucial to providing and achieving optimal care.Objective: To identify the determinants of epilepsy treatment gap (ETG) in children and adolescents (Subjects) with epilepsy in a rural community.Methods: Subjects were identified through a community house to house survey. Information obtained from Subjects and their care givers included: sociodemographic characteristics, type and frequency of epileptic seizures,current and past treatment options utilized, reasons for treatment options used, and treatment options utilized for other health complaints.Results: Twenty three Subjects (6.4/1000 of the child and adolescent population) were identified as having epilepsy. Their age range was 4-19 years (mean 14.3±4.7 years). Most were males (82.6%) and adolescents (78.3%). Seizures were mostly generalized (95.7%) and occurred most frequently daily. Current treatment modalities were use of traditional medication (100%) and prayers (34.8%).None was currently on orthodox medical therapy (ETG, 100%) but 5(21.7%) had utilized orthodox medical therapy in the past. The main determinants of the ETG were strong cultural belief, weakness in the health system to epilepsy treatment and low socioeconomic status. Fever was the commonest other health complaint and use of orthodox medical therapy was significantly (p˂ 0.05) the main (16, 69.6%) treatment option utilized.Conclusion: Cultural belief, weak health system and low socioeconomic status were determinants of an absolute ETG. It highlights the need to strengthen initiatives that enhance accessibility to standard epilepsy treatment.Key words: Epilepsy treatmentgap, determinants, children, adolescents, rural communit

The mental health, quality of life and life satisfaction of internally displaced persons living in Nakuru County, Kenya

Background Internally displaced persons (IDPs) are among the most vulnerable people in the world today. Previous research highlights that conflict-induced forced displacement can cause problems with mental health and wellbeing. This study aimed to contribute to this body of knowledge by investigating the mental health, quality of life, and life satisfaction among IDPs living in Nakuru, Kenya. Methods A questionnaire that included the General Health Questionnaire-12, Satisfaction with Life Scale, and a modified version of the WHO Quality of Life-BREF tool was used for data collection. The questionnaire also included an open-ended question inviting qualitative responses about their experience as an IDP. The questionnaire was distributed through a three-stage sampling approach across four refugee camps from four regions of the Nakuru County in Kenya. Results One hundred IDPs participated in this study. All participants scored substantially higher than the applied GHQ-12 threshold for caseness (mean GHQ-12 score = 28.7, SD = 3.6). Quality of life and life satisfaction scores were also very poor (M = 10.24, SD = 1.9; M = 6.82, SD = 1.5 respectively). The qualitative results reflected these findings with statements reflecting suicidal thoughts, unhappiness with the government, lack of support, and fear for themselves and their children. Significantly higher GHQ-12 scores were found among older IDPs (rho = .202, sig = .046), widowers compared to married IDPs (mean difference = −2.41, SE = .885, sig = .027), while lower scores were found among IDPs who reported having friends as a source of support (U = 834, sig = .045), while quality of life scores were higher among IDPs who reported receiving governmental support (U = 248, sig = .018). Conclusion The findings revealed poor levels of mental health, quality of life and life satisfaction. Older, widowed IDPs and those who did not perceive support from friends or the government were found to be at the highest risk of poor health and wellbeing

Perceptions of psychosocial impacts of epilepsy by affected persons in northern Nigeria

Background Globally persons afflicted with epilepsy suffer social and psychological problems due to factors such as stigmatization and discrimination, overprotection and seclusion by parents and social isolation. This descriptive cross sectional study set out to investigate psychosocial impacts of epilepsy on affected individuals in Kaduna State, Northern Nigeria.Method Two hundred and forty two adults attending epilepsy clinic at two tertiary hospitals were questioned on impacts of epilepsy on personal developments and social interactions.Results The subjects comprised 168 (69.4%) males and 74 (30.6%) females with mean ages of 29.5±12.4years and 30.7 ±16.0 years respectively. Their respective mean ages of onset of epilepsy were 18.6 ±14.0 years and 20.9 ±17.4 years. 8% had no formal education, 50% stopped school at various stages, while 28%, 12% and 2% completed primary, secondary and tertiary education at respective ages of 12.8 ±2.1 years, 18.2 ± 1.9 years and 24.4 ± 0.9 years. 73% were unemployed and 79% were unmarried due to rejection by spouses. More than 90% were unhappy about epilepsy, 4% were depressed and 0.8% had suicidal ideations. 28% would not socialise because of stigmatization and discrimination at home or workplace, while 5% experienced hostility from employers and colleagues at workplace.Conclusions The study highlighted some psychosocial impacts of epilepsy in more than 90% of persons with epilepsy in Kaduna State, Nigeria.Key words: Epilepsy, Nigeria, Perceptions, Psychosocial impact

Impact of childhood mental health disorders on the family: A Case report

Background: Care of the children with mental health disorders is fraught with challenges particularly in developing countries and, where the family isthe major source of care. Consequently assessing the impact of these disorders on the family is relevant to providing these children with optimal care.Objective: To assess the impact of childhood mental health disorderson family function and parental burden.Method: A monogamous family that had 3 children diagnosed as having childhood onset schizophrenia using the International Classification of Disease version 10(ICD 10) Classification was studied. Family function was assessed using the Family APGAR Score and the Zarit Burden Interview(ZBI) Score used in assessing parental burden.\Results: The Family APGAR Scores were low (highly dysfunctional family) and the ZBI Scores high (highly burdened) in the family. Areas of serious dysfunction in the family were in adaptation, partnership and growth.In the ZBI Scores feelings about quality and cost of care offered, stress and other negative attributes associated with providing care, inability to meet other parental obligations and uncertainty about the future, were the major contributors to the highly burdensome outcome.Conclusion: The study highlights significant family burden and dysfunctionin a family who had three children with schizophrenia. It underscored the need for provision of more comprehensive health and social support  services to children with mental health disorders and their families.Key Words: Childhood, Schizophrenia, Parent, Burden, Family functio